Project Summary Washington State University (WSU) proposes research in Kenya to address 7 objectives in Component A, Communicable Disease, of RFA-GH-16-006. The research is organized into three projects that together address the following objectives: Project 1 (i) develop, maintain and expand surveillance systems combining population-based and facility-based demographic, morbidity and mortality surveillance; (ii) develop laboratory capacity and platforms for etiologic investigation and evaluation of novel diagnostic; Project 2 (iii) conduct studies to assess the disease burden, risk factors, and prevention of zoonotic infections; (iv) conduct surveillance and research on antimicrobial resistance; (v) conduct research on the epidemiology and ecology of arboviruses and their vectors; and Project 3 (vi) conduct socio-cultural research on knowledge, attitudes and practice related to infectious disease and acceptance of prevention methods; (vii) develop cost of disease and intervention estimates. To accomplish these objectives, WSU has assembled a team of 20 scientists derived from WSU, University of Nairobi (UON), Emory University, Kenya Medical Research Institute (KEMRI), Kansas State University, and the government of Kenya. In addition, we have enlisted the infrastructural support of KEMRI, UON, and Henry Jackson Foundation. Since 2001, CDC has managed the human demographic surveillance system, rural and urban population-based infectious disease surveillance in Kenya. These platforms and the supporting laboratories were designed to assist in determining the burden of diseases and in conducting disease intervention trials. Here, WSU proposes to start by managing the platforms as-is, but also pilot new approaches to promote their fiscal sustainability. Through the platforms and other surveillance approaches, WSU will investigate the burden and risk factors of endemic and emerging diseases and antimicrobial resistance. In addition, we will conduct intervention studies to address the threats, and engage the government of Kenya to share data and advocate for policy change. Social scientists will work with the disease research team to assess the perceptions of diseases and treatment options, as well as behaviors that may affect human-human and animal-human transmission. To assess the economic burden of disease and cost-effectiveness of interventions, both direct and indirect impacts will be considered. The outcome of this project will be better understanding of level of these threats, and development of interventions that result in improvement of the health of Kenyans and reduction in global health threats.